Ian Mulgrew: Cost of B.C. opioid 'treatment' tops $90 million a year

A patient is handed his daily dose of 85 milligrams of methadone by a nurse (right) from a parked van in Lisbon, Portugal last October. The daily methadone program, run by the Ares do Pinhal Association for Social Inclusion, is part of Portugal's radical turn from 2001 decriminalizing drug use and placing emphasis on treating drug addiction with a public health approach.Horacio Villalobos - Corbis / Corbis via Getty Images

This is not a “cure” but “treatment” — opioid addicts receive medical and social support to stabilize and improve their lives while being encouraged to keep using the pharmaceuticals as long as they help them cope.

The PharmaCare expenditure, which covers “ingredient costs, (pharmacy) dispensing fees and interaction fees,” has increased to $51,465,240 in 2016-17 from $32,170,225 in 2009-10, according to figures provided by the Ministry of Mental Health and Addictions.

They show the MSP cost, which covers physician fees for “case management, counselling, and coordination of care,” has risen to $17, 508,697 last year from $9,174, 378 in 2009-10. It’s about $3,000 a year per patient just for pharmacy costs.

The government also provides a supplement of up to $500 per year to assist with the cost of counselling or related services — add nearly another $3 million for that.

Exacerbating the strain on the health system, these patients visit hospitals far more than others and cost on average an additional $1,000 a year each or about $20 million in 2016.

That’s in total more than $90 million spent on prescription opioid addicts compared to the roughly $80 million spent on legal aid.

And those are just some of the ongoing costs associated with the opioid crisis declared two years ago. There are also the costs of those supplied by the black market, their health care, first responders dealing with overdoses, policing, courts …

In February, a class-action lawsuit settlement also was approved involving some 11,700 patients on the substitution program who received disability assistance.

That will cost another $5.7 million to reimburse the money Victoria wrongly deducted from their cheques.

The new ministry noted it was allocated $322 million in the September 2017 budget update to escalate the province’s response and efforts to get people on “a pathway to treatment and recovery.”

Add to that the federal government’s plan announced in Tuesday’s budget to address the crisis by investing $231.4 million over five years, including a $150-million emergency investment to improve access to treatment programs.

The figures are simply staggering, yet the death toll continues to rise, some 1,422 in 2017 — “the most tragic year ever,” according to chief coroner Lisa Lapointe — and the epidemic rages on.

To say we need to think out of the box is trite, but that’s exactly why it may be time to consider Portugal’s response a generation ago to legalize all drugs and direct funding away from police and enforcement and into more effective public health policies.

Since 2001, in Portugal drug-overdose deaths have plummeted, drug use has declined among 15- to 24-year-olds and there has been a decline in the percentage of the population who have ever used a drug and then continued to do so.

Federal NDP Leader Jagmeet Singh, a former criminal lawyer, and others such as recently retired Chief Medical Officer of Health Perry Kendall have suggested we try the same approach.

Still, we definitely need a solution and we need to rethink how all this money is being spent — too much is flowing into professional pockets and not enough into services and support for patients and the needy to reduce addiction.

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